Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00806 | Date 25/01/2020 |
| Token No | SM/19-20/1807 25/01/2020 | Serial | 014 |
| Patient Name | Mrs. JAYA YADAV | Contact No | |
| Address | PRABASHNAGAR PURBAPARA | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||